Painkiller shortage hits Cape patients

A popular prescription painkiller is in short supply, sending many Cape Cod residents back to their physicians in search of an alternative.

KAREN JEFFREY

A popular prescription painkiller is in short supply, sending many Cape Cod residents back to their physicians in search of an alternative.

Oxycodone, a narcotic prescribed to patients for treatment of moderate to severe pain, is a rare commodity at the moment because two manufacturers have shut down production and issued voluntary recalls.

The recalls, the result of production problems at manufacturing plants, went to suppliers and retail-level sellers of the drug, not individuals, according to the Food and Drug Administration.

"We're all having a hard time getting it because there is such a huge demand for (oxycodone)," said Danielle Rudenauer, a pharmacy technician at the Medicine Shop in Hyannis.

"When people come in with an oxycodone prescription right now, we call their physicians to discuss a possible alternative," she said.

Oxycodone has been around since 1916, when it was first developed by a German scientist. It is synthesized from an opium derivative.

The current shortage has had an impact on patients who might ordinarily be prescribed the drug for acute postoperative pain or chronic pain, said Dr. Andrew Shayne, pain management physician on staff at Falmouth Hospital.

However, he said, there are alternative medications that can be prescribed. "Anyone familiar with analgesic equivalents will know, and pharmacists are well versed in these," Shayne said.

Doctors got no prior warning of the companies stopping production of oxycodone, he said, adding that it has happened before with other drugs.

Some CVS pharmacies may be running short on oxycodone, according to company spokesman Michael DeAngelis. But that should be resolved by May, he said.

The Rhode Island-based pharmacy chain made arrangements in January, when the first recall was announced, "for an alternative generic manufacturer to supply us," DeAngelis said. He noted that it takes time for a company to get production up and running.

One of the major manufacturers of oxycodone, Missouri-based KV Pharmaceutical Co., stopped production and issued a recall to distributors when it was discovered its tablets were oversized, according to the American Society of Health-System Pharmacists.

Another drug company, Actavis, headquartered in New Jersey, stopped manufacturing the drug when its plants did not meet company or FDA standards for good manufacturing practices. The FDA did not specify what standards were not met.

Across the country, hospitals are also scrambling to find new suppliers.

But that's not the case here. Cape Cod Hospital has a sufficient supply for its patients, according to Matthew Pernick, pharmacist and supervisor of the hospital pharmacy. "We were able to juggle our inventory around so that we were never out of it," Pernick said.

Also, he said, the hospital has an automatic ordering system that prevents the stock of specific drugs from running low.

Oxycodone is prescribed in varying levels of strength and can be combined with other medications such as Percocet, a combination of oxycodone and acetaminophen.

Oxycodone can be prescribed for a number of ailments and injuries including ear infections and toothaches. In its stronger forms, it is an accepted medication for cancer patients.

Clients of Hospice & Palliative Care of Cape Cod have not had to go without the drug, said Melissa Weidman, marketing director. The agency gets drugs directly from suppliers, including those that deal regularly with hospice organizations, she said. "We have very good relationships with vendors, including some that are particularly hospice-friendly," she said.

"A shortage of any of these kinds of medications — those with proven ability — is disheartening at any time for cancer patients," said Chris Lucas, spokesman for the Massachusetts branch of the American Cancer Society. Oxycodone has been shown to provide "immeasurable relief to some patients," he said. "It is hard enough dealing with the disease. Being unable to get a drug to help with pain management makes it all the more difficult."

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